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Abnormal development of the placenta

The foetus dies at a very early stage, but the placental cells continue to grow, then swell, and form vesicles about the size of a grape. A hydatidiform pregnancy seems normal in the early stages, but morning sickness is more frequent, and the womb grows rapidly in proportion to the length of the pregnancy; the uterus is soft, and neither the child’s limbs nor a heartbeat can be felt; no foetus shows on an ultrasound scan. Abnormal production of the pregnancy hormone HCG is another strong indication of a hydatida-form mole (this is the hormone found in the mother’s urine in a positive pregnancy test). Growth usually declines between the 10th and 20th weeks, and there is often severe haemorrhage, giving the impression of a miscarriage. If a hydatidiform pregnancy is suspected, it should be terminated, particularly as there is a chance of the hydatidiform mole developing into a malignant tumour (choriocarcinoma). Labour should be induced, followed by a curettage to remove any remaining fragments. The urine should afterwards be regularly checked for pregnancy hormone. To avoid complications, at least a year should elapse before the next pregnancy.

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